Healthcare Expansion Efforts Turn Incremental

While discussion of universal healthcare (also known as “single payer”) will likely continue at the national level, here in California, proposals emerging from the Governor’s Office and from legislative policymakers indicate a turn to a more measured, incremental approach toward increased healthcare accessibility, affordability, and coverage.

In January, Governor Gavin Newsom released his state budget proposal for the 2019-2020 fiscal year. Since then, some of his health-related items have been working their way through the legislative process in anticipation of the Governor’s budget revisions released in May (traditionally known as the “May Revision”). The May Revision is a very telling document, as it generally presents a clearer picture of which proposals, especially new spending proposals, are having some success moving toward actual implementation.

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Having seen the Governor’s more progressive budgetary priorities focus heavily on healthcare, policy makers have set forth similar but not identical goals.

If there is a compromise between what the governor proposes and what legislative leaders adopt, the final legislative language will likely be written in the budget trailer bill process, potentially up until the mandated June 15 deadline to pass the state budget. Items currently moving through the legislative process to watch include:

SB 29/AB 4 — Increasing Medi-Cal Coverage (Sen. Durazo, D-Los Angeles/Asm. Arambula, D-Fresno)

These bills would extend Medi-Cal eligibility to all income-eligible adults regardless of their immigration status. The Governor’s proposal on this issue is limited to young adults ages 19–25 years old. 

SB 65/AB 174 — Affordability (Sen. Pan, D-Sacramento/Asm. Wood, D-Santa Rosa)

These bills would require Covered California (the state’s federal health exchange) to provide more financial help to low-income residents buying insurance through the exchange. The Assembly bill would establish a tax credit beginning in 2020 for individuals between 400 and 600 percent of the federal poverty level. The Senate bill requires Covered California to reduce copayments and deductibles for people with incomes between 200 and 400 percent of the federal poverty level. Both of these bills would match Governor Newsom’s proposal to establish an individual mandate for California residents, including a state-level penalty for people who do not carry health insurance. Revenue generated from the penalties would fund subsidies in Covered California plans with the aim of increasing affordability. 


Gabriela Villanueva is CAP’s Public Affairs Analyst. Questions or comments related to this article should be directed to